Pediatric heart murmur

What is a pediatric heart murmur?

A pediatric heart murmur is an extra sound in your child’s heartbeat, caused by turbulent blood flow through the heart. A normal heartbeat makes two sounds, like "lub-dup," as the heart valves open and close. A heart murmur sounds like whooshing or swishing during a heartbeat.

Heart murmurs are very common in children, and most heart murmurs are normal and don’t cause any symptoms. In rare cases, a heart murmur can be a sign of a structural problem in the heart. Your child’s doctor can evaluate the murmur to decide if your child needs more testing to determine the cause.

What are the different types of pediatric heart murmurs?

Heart murmurs make a variety of sounds, and in general, there are two types.

1. Innocent heart murmurs are harmless, don’t cause symptoms and don’t need any treatment. This type is very common – more than two-thirds of children have one at some point during childhood. Your child can lead a healthy, active life, and the heart murmur will likely go away by adulthood.

2. Abnormal heart murmurs typically result from a heart condition that your child is born with (congenital heart disease), which affects the heart’s structure.

   • Sometimes, an abnormal heart murmur can develop after an infection or other condition. This type of murmur is called acquired. Although an abnormal heart murmur is usually not life-threatening, your child needs evaluation and possibly treatment for the cause.

What are the signs and symptoms of a pediatric heart murmur?

• Poor feeding, eating, growth or weight gain

• Rapid breathing or shortness of breath

• Extreme fatigue

• Fainting or dizziness

• Chest pain

• Bluish skin, especially on the lips and fingertips

• Swelling in the neck, belly (abdomen), lower legs, ankles or feet

These signs and symptoms can occur in children who have abnormal heart murmurs. Children who have innocent heart murmurs usually experience no symptoms.

How is a pediatric heart murmur diagnosed?

At Children’s Health, our pediatric cardiologists begin with a thorough evaluation. We do a physical exam and ask you about your child’s medical history.

This includes:

• Careful examination of their heart using a stethoscope to listen closely

• Recent signs and symptoms

• Family medical history, especially if other family members have had a heart murmur or other heart condition

Based on the physical exam and history, our cardiologists can sometimes determine that the murmur is an innocent heart murmur without any further tests.

If additional testing is needed, your doctor my order:

• Electrocardiogram (EKG/ECG) - This painless, noninvasive test records the electrical activity of your child’s heart. An EKG can show signs of problems with the heart‘s rhythm (arrhythmia) or structure.

• Echocardiogram (echo) - This test is an ultrasound of your child’s heart to look at its structure as it moves. Also painless and noninvasive, an echo can show problems such as abnormal heart valves or holes in the heart.

• Chest X-ray - X-ray imaging of your child’s heart, lungs and blood vessels can show signs of other conditions that may be causing the heart murmur.

What causes a pediatric heart murmur?

If your child has an innocent heart murmur, their heart is normal.

Abnormal heart murmurs in children usually result from a congenital heart disease, such as:

• Atrial septal defect - A hole in the wall between the heart’s two upper chambers

• Ventricular septal defect - A hole in the wall between the heart’s two lower chambers

• Heart valve diseases - Occurs when one or more of the heart's four valves have a problem

• Cardiac shunts - Abnormal blood flow through the heart

• Endocarditis - A infection in heart valves

• Rheumatic fever

• Anemia - Low red blood cell count

• Hyperthyroidism - Overactive thyroid gland

How is a pediatric heart murmur treated?

Our pediatric cardiologists decide on treatment for a pediatric heart murmur based on what its type and cause.

• Innocent heart murmurs don’t need any treatment because the heart is normal and the murmur usually goes away on its own.

• For abnormal heart murmurs, we treat the underlying cause.

  • Regular monitoring - Your child comes in for checkups and testing to see if the murmur is causing any symptoms.

  • Medication - We can prescribe a variety of medications to address the specific causes of the murmur and help your child’s heart work better.

  • Cardiac catheterization - Our skilled pediatric interventional cardiologists perform minimally invasive techniques to repair structural heart diseases. These procedures use a catheter (long, narrow tube) with special instruments inserted through a blood vessel to access and treat your child’s heart.

  • Open-heart surgery or cardiothoracic surgery - Our experienced heart surgeons perform open-heart surgery to repair structural heart diseases. These traditional surgical procedures use a longer incision to access and treat the condition.